Week 11- Newborn Physical Exam Flashcards
Normal newborn head circ:
12-15 inches
Normal newborn weight:
5lbs 8oz- 8lb 13oz
Normal newborn length:
18-22 inches
Normal newborn temp:
97.7-99 F
Normal newborn HR:
80-180 bpm
Normal newborn RR:
30-60 bpm
When is the screening for congenital heart disease done after birth?
After 24 hours and before discharge
What are normal results for the congenital heart screening?
Both pre and post ductal sats greater than 95% and less than a 3% difference between the hand and foot.
This is a bluish discoloration of the hands and feet of newborns that is normal for the first 24-48 hours of life due to immature cardiac circulation and in older infants due to cold stress.
Acrocyanosis
This is unilateral color change on one side of the newborns body and is more common in low birth weight infants.
Harlequin sign
What is the harlequin sign due to and how long does it typically last?
Due to vasomotor instability
Transient, harmless, lasts 10-20 minutes
This occurs in 30-70% of newborns and is white or yellow, 1-3mm papules over erythematous base. It can occur anywhere on the body, but usually spare the palmar surfaces.
Erythema toxicum
This is exposed sebaceous glands that appear as whiteheads and disappear within the first month of life with no treatment.
Milia
These are bluish-grey pigmentation of the skin that are typically located on the lower back, across shoulders, hips and legs. More common in dark skinned newborns and can fade over time.
Mongolian spots
This is a raised capillary nevi that can occur anywhere on the body. Can increase in size over the first few months of life and generally disappear by age 10.
Strawberry hemangioma
When do you refer with a strawberry hemangioma?
With orbital hemangioma, very large hemangiomas, or those with potential to interfere with the airway.
These are pale pink or reddish discoloration of the skin normally located on the nape of the neck, the lower axillae, nasal bridge, or eyelids.
Stork bite or nevus flamus
When do stork bites typically resolve?
2 years of age
This is fine, soft hair that covers the newborn’a back, shoulders, cheeks, forehead, and scalp that is more common in premature infants. It disappears within first month of life.
Lanugo
This is a line of increase pigmentation from umbilicus to genitalia. More common in darker skinned infants.
Linea nigra
This is the cheesy, gray-white substance covering and protecting the skin during fetal life that diminishes near term.
Vernix caseosa
This appears at 3-4 weeks of age and is caused by maternal hormones which stimulate the infants sebaceous glands. It is more common in males and no treatment is needed.
Neonatal acne
This is normal when found on presenting parts of the infant.
Petechiae
Petechiae anywhere other than the presenting parts of the infant may indicate what?
Infection
These are hyperpigmented lesions, usually macules that are irregular in shape and light brown in color.
Cafe-au-lait spots
A newborn with 6 or more cafe-au-lait spots bigger than 1cm must be worked up for:
Neurofibromatosis
This occurs in health infants, appears the same, and improves as skin is warmed?
Cutis marmorata
Mottling May be due to:
Hypothermia or infection
Pallor or paleness of the skin may be caused by:
Anemia or infection
Anterior fontanel is ___ shapes and closes by ____.
Diamond shaped
Closes by 18 months
Posterior fontanel is ___ shaped and closes by___.
Triangle shaped
Closes by 4months
How many sutures total?
5 total
This is a collection of blood under the periosteum caused by pressure during labor or operative measures.
Do NOT cross suture lines.
Cephalohematoma
Cephalohematomas typically resolve in:
6-8 weeks without intervention
This is localized swelling of the soft tissues of the scalp caused by pressure during labor and birth.
These DO cross suture lines.
Caput succedaneum
Caput succedaneum typically resolves in:
24-48 hours after birth spontaneously
Newborns can fix and focus on an object how far from face?
8-10 inches
Permanent eye color by:
3-6 months
Hypertelorism is:
Eyes too far apart
Hypotelorism is:
Eyes too close together
Cornea haziness could indicate:
Glaucoma
Absent red reflex can indicate:
Infection or cataracts
Grey or white pupil could indicate:
Retinoblastoma
This is eye openings too small and could indicate chromosomal anomaly or syndrome.
Palpebral fissures
This is slanting of the eyes:
Epicanthal folds
Ankyloglossia can cause:
Difficulty feeding and latching. Some tissue is anatomically normal and not all tongue ties require repair.
Cysts on top of the mouth:
Ebstein pearls and normally resolve by 1m of age.
Average newborn chest circ:
33cm or 2cm less than head circ
CN1 assessment in infants:
Olfactory- alcohol wipe under nose should elicit a grimace
CN II, III, IV, and VI assessment in newborns:
II- optic III- oculomotor IV- trochlear VI- abducens Light in eye causes rapid closure Baby’s head should follow your face 8-10 inches away
CN V, IX, and XII assessment:
V- trigeminal IX- glossopharyngeal XII- hypoglossal Rooting and sucking reflexes Swallowing assessed by observing latch
CN VII assessment:
Facial- glabella rap for blinking
CN VIII assessment
Auditory- assess infant in a quiet room to observe their reaction to sound
